<!--找回登录密码-->
<div class="container _donation">
  <div class="row">
    <div class="col-lg-6 col-lg-offset-3">
      <h4 class="_donation-title">捐款支持</h4>
      <ul class="_donation-progress">
        <li class="active1"><span></span>
          <p>选择捐款额度</p>
        </li>
        <li class="active2"><span></span>
          <p>选择付款方式</p>
        </li>
        <li><span></span>
          <p>捐款成功</p>
        </li>
      </ul>
      <h5 class="_donation-name">
        <div class="_donation-name-text">选择信用卡支付</div>
        <div class="_donation-name-bank">
          <img src="assets/img/bank/bank_unionpay.png" width="43px" height="34px"/>
          <img src="assets/img/bank/bank_mastercard.png" width="54px" height="34px"/>
          <img src="assets/img/bank/bank_visa.png" width="43px" height="34px"/>
        </div>
      </h5>
      <form role="form" class="form-horizontal _form" id="form" name="form">
        <div class="form-group">
          <div class="form-div"><label for="Name" class="col-sm-6 col-xs-12 form-tip">请输入您的信用卡信息</label></div>
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control" id="Name" name="Name" #firstname placeholder="姓">
          </div>
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control" id="Card" name="Card" #lastname placeholder="名">
          </div>
        </div>
        <div class="form-group">
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control"  name="Name" #address placeholder="您的地址">
          </div>
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control"  name="Card" #city placeholder="城市">
          </div>
        </div>
        <div class="form-group">
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control"  name="Name" #state placeholder="省/市">
          </div>
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control"  name="Card" #zipcode placeholder="邮政编码">
          </div>
        </div>
        <div class="form-group">
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control"  name="Name" #country placeholder="国家">
          </div>
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control"  name="Card" #email placeholder="邮箱">
          </div>
        </div>
        <div class="form-group">
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control"  name="Name" #phone placeholder="手机">
          </div>
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control"  name="Card" #cardnum placeholder="银行卡号">
          </div>
        </div>
        <div class="form-group">
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control"  name="Name" #cvv2 placeholder="cvv2">
          </div>
          <div class="col-sm-6 col-xs-12">
            <input type="text" class="form-control"  name="Name" #cardname placeholder="银行全称">
          </div>
        </div>
        <div class="form-group">
          <div class="col-xs-12">
            <div class="form-div"><label class="form-tip">信用卡有效期</label></div>
            <div class="form-select-inline">
              <div class="has-feedback" >
                <select  class="form-control form-select-input" #month>
                  <option>01</option>
                  <option>02</option>
                  <option>03</option>
                  <option>04</option>
                  <option>05</option>
                  <option>06</option>
                  <option>07</option>
                  <option>08</option>
                  <option>09</option>
                  <option>10</option>
                  <option>11</option>
                  <option>12</option>
                </select>
              </div>

              <div class="has-feedback" >
                <select  class="form-control form-select-input" #year>
                  <option>2017</option>
                  <option>2018</option>
                  <option>2020</option>
                  <option>2021</option>
                  <option>2022</option>
                  <option>2023</option>
                  <option>2024</option>
                </select>
              </div>
            </div>

            <p class="help-block">注：只有银联信用卡用户需要填写卡验证码与手机号，其他信用卡用户无需填写。</p>
          </div>
        </div>
        <div class="form-group form-btn">
          <div class="col-xs-3 col-xs-offset-9">
            <button type="submit" class="btn btn-submit">添加此信用卡</button>
          </div>
        </div>
        <h5 class="_donation-title">选择支付宝付款</h5>
        <div class="form-tip">
          您将被转至第三方网站支付订单
        </div>
        <div class="form-group form-btn">
          <div class="col-xs-3 col-xs-offset-9">
            <a class="btn btn-submit">支付宝付款</a>
          </div>
        </div>
        <div class="form-group form-btn">
          <div class="col-sm-6 col-sm-offset-3 col-xs-12">
            <a (click)="givecardinfro(firstname.value, lastname.value,email.value,phone.value,zipcode.value,address.value,city.value,state.value,country.value,cardnum.value,cvv2.value,
                month.value,year.value,cardname.value,inf,'02')" class="btn btn-submit">下一步</a>
          </div>
        </div>
      </form>
    </div>
  </div>
</div>
